tci Part B Insider - 2012 Issue 18

Reader Question: Avoid 79101 on 78452 Claim

Question: Why am I getting denials for radiopharmaceutical injection (79101) with MPI (CPT 78452 )?Answer: These two codes are bundled, and you may not override the bundle. Code 79101 (Radiopharmaceutical therapy, by intravenous administration) is appropriate for IV administration for radiopharmaceutical therapy.You should not use it for a diagnostic test such as 78452 (Myocardial perfusion imaging, tomographic [SPECT] [including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed]; multiple studies, at rest and/or stress [exercise or pharmacologic] and/or redistribution and/or rest reinjection).Don't forget: If your physician...

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